scholarly journals Knee pain and future decline in higher-level functional competence in community-dwelling older Japanese: the Kurabuchi cohort study

2020 ◽  
Vol 49 (4) ◽  
pp. 592-598
Author(s):  
Keiko Sugai ◽  
Takehiro Michikawa ◽  
Toru Takebayashi ◽  
Yuji Nishiwaki
Keyword(s):  
Cohort Study ◽  
Older People ◽  
Knee Pain ◽  
Functional Impairment ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Cox Proportional Hazards Model ◽  
Social Activities ◽  
Functional Competence

Abstract Background The effect of knee osteoarthritis, which causes knee pain, on higher-level functional competence (HLFC) is not clear. Objective To clarify the effect of knee pain on HLFC in older people. Design Community-based prospective cohort study. Setting Kurabuchi town, Gumma prefecture, Japan. Subjects Community-dwelling individuals aged 65 and older. Methods A total of 808 residents participated to the baseline examinations. The frequency of knee pain, degree of pain and functional impairment resulting from the pain were asked at baseline (2005–2006) via a self-administered questionnaire in Japanese based on an English version of the Western Ontario and McMaster Universities Osteoarthritis Index. Information on HLFC at baseline and during home visits were collected annually until 2014 with the Tokyo Metropolitan Institute of Gerontology Index of Competence. The association between baseline knee pain and HLFC decline was assessed with a Cox proportional hazards model. Results Two factors, persistent knee pain and severe functional impairment caused by the pain, were significantly associated with future declines in total HLFC, with adjusted hazard ratios (95% confidence intervals) of 1.51 (1.08–2.11) and 1.49 (1.10–2.00). In analysis by subcategory, persistent knee pain had a significant adverse effect on participants’ intellectual and social activities, and that severe physical functional impairment also had a significant impact on social activities. Conclusions The clear association of the frequency of knee pain and resultant functional impairment with future HLFC decline indicates that collecting information about these factors may be useful in identifying older people at high risk of future HLFC decline.

Brazilian Older People Hospitalized by COVID-19: Characteristics and Prognostic Factors in a Retrospective Cohort Study

2021 ◽  
pp. 073346482098397
Author(s):  
Marquiony M. Santos ◽  
Eudes E. S. Lucena ◽  
Diego Bonfada ◽  
Aramis Costa Santos ◽  
Hareton Teixeira Vechi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Older People ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Access To Health Services ◽  
Multicenter Cohort Study ◽  
Risk Of Death ◽  
Increased Risk

Objective: Analyzing the survival of older people hospitalized due to COVID-19 in Brazil and identifying its main predictive factors for death. Method: This is a retrospective, multicenter cohort study, based on 20,831 records of hospitalizations of older people due to SARS-CoV-2 in Brazil. The observation period was from February 28 to May 18, 2020. Results: There was a reduced overall survival time of 47.70% (95% confidence interval [CI] = [46.72%, 48.67%]) in 10 days. The variables age, race, education, intensive care unit (ICU), region, day of hospitalization, time elapsed between the first symptom and hospitalization, and the municipality that provided assistance showed increased risk of death using the multiple Cox proportional-hazards model. Conclusion: These results emphasize the relevance of inequality and access to health services as determinants for the death of older people with COVID-19.

scholarly journals Regular Use of VKA Prior to COVID-19 Associated with Lower 7-Day Survival in Hospitalized Frail Elderly COVID-19 Patients: The GERIA-COVID Cohort Study

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 39
Author(s):  
Pierre Ménager ◽  
Olivier Brière ◽  
Jennifer Gautier ◽  
Jérémie Riou ◽  
Guillaume Sacco ◽  
...  
Keyword(s):  
Cohort Study ◽  
Vitamin K ◽  
Frail Elderly ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Clinical Severity ◽  
Survival Times ◽  
Short Term Mortality

Background. Vitamin K concentrations are inversely associated with the clinical severity of COVID-19. The objective of this cohort study was to determine whether the regular use of vitamin K antagonist (VKA) prior to COVID-19 was associated with short-term mortality in frail older adults hospitalized for COVID-19. Methods. Eighty-two patients consecutively hospitalized for COVID-19 in a geriatric acute care unit were included. The association of the regular use of VKA prior to COVID-19 with survival after 7 days of COVID-19 was examined using a propensity-score-weighted Cox proportional-hazards model accounting for age, sex, severe undernutrition, diabetes mellitus, hypertension, prior myocardial infarction, congestive heart failure, prior stroke and/or transient ischemic attack, CHA2DS2-VASc score, HAS-BLED score, and eGFR. Results. Among 82 patients (mean ± SD age 88.8 ± 4.5 years; 48% women), 73 survived COVID-19 at day 7 while 9 died. There was no between-group difference at baseline, despite a trend for more frequent use of VKA in those who did not survive on day 7 (33.3% versus 8.2%, p = 0.056). While considering “using no VKA” as the reference (hazard ratio (HR) = 1), the HR for 7-day mortality in those regularly using VKA was 5.68 [95% CI: 1.17; 27.53]. Consistently, COVID-19 patients using VKA on a regular basis had shorter survival times than the others (p = 0.031). Conclusions. Regular use of VKA was associated with increased mortality at day 7 in hospitalized frail elderly patients with COVID-19.

scholarly journals Associations between SARS-CoV-2 variants and risk of COVID-19 hospitalization among confirmed cases in Washington State: a retrospective cohort study

2021 ◽  
Author(s):  
Miguel I. Paredes ◽  
Stephanie Lunn ◽  
Michael Famulare ◽  
Lauren A. Frisbie ◽  
Ian Painter ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Sentinel Surveillance ◽  
Cox Proportional Hazards Model ◽  
Ancestral Lineage ◽  
Significant Difference

Background: The COVID–19 pandemic is now dominated by variant lineages; the resulting impact on disease severity remains unclear. Using a retrospective cohort study, we assessed the risk of hospitalization following infection with nine variants of concern or interest (VOC/VOI). Methods: Our study includes individuals with positive SARS–CoV–2 RT PCR in the Washington Disease Reporting System and with available viral genome data, from December 1, 2020 to July 30, 2021. The main analysis was restricted to cases with specimens collected through sentinel surveillance. Using a Cox proportional hazards model with mixed effects, we estimated hazard ratios (HR) for the risk of hospitalization following infection with a VOC/VOI, adjusting for age, sex, and vaccination status. Findings: Of the 27,814 cases, 23,170 (83.3%) were sequenced through sentinel surveillance, of which 726 (3.1%) were hospitalized due to COVID–19. Higher hospitalization risk was found for infections with Gamma (HR 3.17, 95% CI 2.15–4.67), Beta (HR: 2.97, 95% CI 1.65–5.35), Delta (HR: 2.30, 95% CI 1.69–3.15), and Alpha (HR 1.59, 95% CI 1.26–1.99) compared to infections with an ancestral lineage. Following VOC infection, unvaccinated patients show a similar higher hospitalization risk, while vaccinated patients show no significant difference in risk, both when compared to unvaccinated, ancestral lineage cases. Interpretation: Infection with a VOC results in a higher hospitalization risk, with an active vaccination attenuating that risk. Our findings support promoting hospital preparedness, vaccination, and robust genomic surveillance.

scholarly journals Social Participation and Functional Decline: A Comparative Study of Rural and Urban Older People, Using Japan Gerontological Evaluation Study Longitudinal Data

2020 ◽  
Vol 17 (2) ◽  
pp. 617 ◽  
Author(s):  
Kazushige Ide ◽  
Taishi Tsuji ◽  
Satoru Kanamori ◽  
Seungwon Jeong ◽  
Yuiko Nagamine ◽  
...  
Keyword(s):  
Longitudinal Data ◽  
Older People ◽  
Social Participation ◽  
Urban Areas ◽  
Proportional Hazards Model ◽  
Functional Decline ◽  
Evaluation Study ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Rural And Urban

This study compared the relationship between social participation, including work, and incidence of functional decline in rural and urban older people in Japan, by focusing on the number and types of organizations older people participated in. The longitudinal data of the Japan Gerontological Evaluation Study (JAGES) that followed 55,243 individuals aged 65 years or older for six years were used. The Cox proportional hazards model was employed to calculate the hazard ratio (HR) of the incidence of functional decline over six years and the stratification of rural and urban settings. In this model, we adjusted 13 variables as behavioral, psychosocial, and functional confounders. The more rural and urban older people participated in various organizations, the more they were protected from functional decline. Participation in sports (HR: rural = 0.79; urban = 0.83), hobby groups (HR: rural = 0.76; urban = 0.90), and work (HR: rural = 0.83; urban = 0.80) significantly protected against the incidence of decline in both rural and urban areas. For both rural and urban older people, promoting social participation, such as sports and hobby groups and employment support, seemed to be an important aspect of public health policies that would prevent functional decline.

scholarly journals Effects of Urate-Lowering Therapy on Risk of Hyperlipidemia in Gout by a Population-Based Cohort Study and on In Vitro Hepatic Lipogenesis-Related Gene Expression

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Yi-Jen Fang ◽  
Tien-Yuan Wu ◽  
Cheng-Li Lin ◽  
Chih-Yang Su ◽  
Jia-Rong Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Proportional Hazards Model ◽  
Treatment Guidelines ◽  
Strong Association ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Case Group ◽  
Control Cohort ◽  
Hepatic Expression ◽  
Lowering Therapy

Patients with gout are at a higher risk of cardiovascular disease, which is associated with hyperlipidemia. Management of gout in Taiwan is poor, and the association between urate-lowering therapy (ULT) among gout patients and hyperlipidemia is unclear. We conducted a retrospective cohort study using data from the Longitudinal Health Insurance Database (LHID) of Taiwan on new-onset gout patients and a comparison cohort without gout. A Cox proportional hazards model was used to analyze differences in the risk of hyperlipidemia between patients with and without gout after considering related comorbidities. We also examined the ULT medications on the hepatic expression of lipogenesis-related genes. After adjusting for potential confounders, the case group (44,413 patients) was found to have a higher risk of hyperlipidemia than the control cohort (177,652 patients) [adjusted hazards ratio aHR = 2.55 ]. Gout patients without antigout treatment had significantly higher risk of hyperlipidemia than the control cohort ( aHR = 3.10 ). Among gout patients receiving ULT, except those receiving probenecid ( aHR = 0.80 ), all had significantly lower risk of hyperlipidemia than gout patients without ULT (all aHR < 0.90 ). Using real-time polymerase chain reaction, we found that most of the antigout drugs decreased the expression of hepatic genes related to lipogenesis in differentiated HepaRG cells. These data indicate that these antigout drugs reduce hyperlipidemia in gout patients, partly via the reduction in expression of lipogenesis-related genes, leading to improved blood lipid profiles. We provide evidence of the strong association between gout and hyperlipidemia and highlight the need for appropriate treatment guidelines.

scholarly journals Circulating Inflammatory and Hemostatic Biomarkers are Associated with All-Cause Death and Cancer Death in a Population of Community-Dwelling Japanese: The Tanushimaru Study

2014 ◽  
Vol 8s3 ◽  
pp. CMC.S17065
Author(s):  
Mika Enomoto ◽  
Hisashi Adachi ◽  
Ako Fukami ◽  
Ayako Yoshimura ◽  
Aya Obuchi ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Inflammatory Diseases ◽  
Cox Proportional Hazards ◽  
Predictive Markers ◽  
Community Dwelling ◽  
Cox Proportional Hazards Model ◽  
Cancer Death ◽  
Hazards Model

Background In patients with cardiovascular diseases, inflammatory and hemostatic biomarkers are significant indicators of prognosis. We investigated whether circulating inflammatory and hemostatic biomarkers were predictive markers for all-cause death and cancer death in a population of community-dwelling Japanese. Methods We studied 1,920 healthy Japanese adults who underwent health examinations in 1999. Those who reported a history of inflammatory diseases and malignancy on a baseline questionnaire were excluded. Inflammatory and hemostatic biomarkers were measured in the remaining 1,862 participants, who were followed up periodically for 10 years. Multivariate proportional hazards regression analysis was used to estimate all-cause and cancer mortality. Results A total of 258 participants died during follow-up: 87 from cancer, 38 from cerebro-cardiovascular diseases, and 133 from other diseases. Mean C-reactive protein (CRP) levels at baseline were significantly higher in decedents than in survivors. Mean von Willebrand factor (vWF) levels at baseline were significantly higher in decedents than in survivors. The Cox proportional hazards model after adjustments for age and sex showed that CRP (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.06-1.51) and vWF (HR, 1.01; 95% CI, 1.00-1.01) were independent predictors of all-cause death. CRP (HR, 1.40; 95% CI, 1.06-1.86) and vWF (HR, 1.01; 95% CI, 1.00-1.02) were also independent predictive markers for cancer death. Conclusions Serum CRP and vWF were predictors of all-cause death and cancer death in the population of community dwelling Japanese.

scholarly journals Fish intake and the risk of fatal prostate cancer: findings from a cohort study in Japan

2009 ◽  
Vol 12 (5) ◽  
pp. 609-613 ◽  
Author(s):  
Truong-Minh Pham ◽  
Yoshihisa Fujino ◽  
Tatsuhiko Kubo ◽  
Reiko Ide ◽  
Noritaka Tokui ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cohort Study ◽  
Fish Consumption ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Inverse Association ◽  
High Intake ◽  
Risk Of Death

AbstractObjectiveWe investigated the relationship between the intake of fish and the risk of death from prostate cancer.DesignData were derived from a prospective cohort study in Japan. Fish consumption obtained from a baseline questionnaire was classified into the two categories of ‘low intake’ and ‘high intake’. The Cox proportional hazards model was used to estimate hazard ratios (HR) and 95 % confidence intervals.SubjectsData for 5589 men aged 30–79 years were analysed.ResultsA total of twenty-one prostate cancer deaths were observed during 75 072 person-years of follow-up. Mean age at baseline study of these twenty-one subjects was 67·7 years, ranging from 47 and 79 years old. Results showed a consistent inverse association of this cancer between the high v. low intake groups. The multivariate model adjusted for potential confounding factors and some other food items showed a HR of 0·12 (95 % CI 0·05, 0·32) for the high intake group of fish consumption.ConclusionsThese results support the hypothesis that a high intake of fish may decrease the risk of prostate cancer death. Given the paucity of studies examining the association between prostate cancer and fish consumption, particularly in Asian populations, these findings require confirmation in additional cohort studies.

scholarly journals Predictors for depressive symptoms by four types of disability

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sun Wook Jung ◽  
Jin-Ha Yoon ◽  
Wanhyung Lee
Keyword(s):  
Depressive Symptoms ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Depressive Symptomatology ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Cox Proportional Hazards Model ◽  
Mental Disability ◽  
Multivariate Logistic Regression Model ◽  
Industrial Disaster

AbstractThis study aimed to examine the longitudinal relationship between disability and depressive symptoms, by comparing four types of disability in community-dwelling individuals with disabilities in South Korea. A total of 3347 South Koreans with disabilities from the second wave of the Panel Survey of Employment for the Disabled was utilized. Depressive symptomatology was assessed by whether the participant had experienced depressive symptoms for more than two weeks during the past year. A multivariate logistic regression model was used to calculate the odds ratio (OR) for depressive symptoms, and a Cox proportional hazards model to calculate the hazard ratio (HR) for two-year survival analysis. Persons who acquired mental disability from accident or industrial disaster and persons with congenital physical-internal disability were at higher risk for depressive symptoms. Maintaining employment was found to be an effective way to decrease the risk of depressive symptoms in persons with physical-external disability, sensory/speech disability, or mental disability. In contrast, in physical-internal disability, retaining normal ability to work seemed to be the key to reduce the risk of depressive symptoms. Predictors of depressive symptoms were found to differ depending on the type of disability. Such differences should be reflected in clinical and policy-level interventions to address the specific psychiatric needs of persons with different disabilities.

scholarly journals Outcomes in Critically Ill Patients Sedated with Intravenous Lormetazepam or Midazolam: A Retrospective Cohort Study

2021 ◽  
Vol 10 (18) ◽  
pp. 4091
Author(s):  
Björn Weiss ◽  
David Hilfrich ◽  
Gerald Vorderwülbecke ◽  
Maria Heinrich ◽  
Julius J. Grunow ◽  
...  
Keyword(s):  
Cohort Study ◽  
Critically Ill ◽  
Retrospective Cohort Study ◽  
Critically Ill Patients ◽  
Retrospective Cohort ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Medical Center ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model

The benzodiazepine, midazolam, is one of the most frequently used sedatives in intensive care medicine, but it has an unfavorable pharmacokinetic profile when continuously applied. As a consequence, patients are frequently prolonged and more deeply sedated than intended. Due to its distinct pharmacological features, including a cytochrome P450-independent metabolization, intravenous lormetazepam might be clinically advantageous compared to midazolam. In this retrospective cohort study, we compared patients who received either intravenous lormetazepam or midazolam with respect to their survival and sedation characteristics. The cohort included 3314 mechanically ventilated, critically ill patients that received one of the two drugs in a tertiary medical center in Germany between 2006 and 2018. A Cox proportional hazards model with mortality as outcome and APACHE II, age, gender, and admission mode as covariates revealed a hazard ratio of 1.75 [95% CI 1.46–2.09; p < 0.001] for in-hospital mortality associated with the use of midazolam. After additionally adjusting for sedation intensity, the HR became 1.04 [95% CI 0.83–1.31; p = 0.97]. Thus, we concluded that excessive sedation occurs more frequently in critically ill patients treated with midazolam than in patients treated with lormetazepam. These findings require further investigation in prospective trials to assess if lormetazepam, due to its ability to maintain light sedation, might be favorable over other benzodiazepines for sedation in the ICU.

scholarly journals The influence of leprosy-related clinical and epidemiological variables in the occurrence and severity of COVID-19: A prospective real-world cohort study

2021 ◽  
Vol 15 (7) ◽  
pp. e0009635
Author(s):  
Selma Regina Penha Silva Cerqueira ◽  
Patrícia Duarte Deps ◽  
Débora Vilela Cunha ◽  
Natanael Victor Furtunato Bezerra ◽  
Daniel Holanda Barroso ◽  
...  
Keyword(s):  
Cohort Study ◽  
Real World ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Significant Risk ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Protective Effects ◽  
Bcg Vaccination ◽  
Patients At Risk

Background Protective effects of Bacillus Calmette–Guérin (BCG) vaccination and clofazimine and dapsone treatment against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported. Patients at risk for leprosy represent an interesting model for assessing the effects of these therapies on the occurrence and severity of coronavirus disease 2019 (COVID-19). We assessed the influence of leprosy-related variables in the occurrence and severity of COVID-19. Methodology/Principal findings We performed a 14-month prospective real-world cohort study in which the main risk factor was 2 previous vaccinations with BCG and the main outcome was COVID-19 detection by reverse transcription polymerase chain reaction (RT-PCR). A Cox proportional hazards model was used. Among the 406 included patients, 113 were diagnosed with leprosy. During follow-up, 69 (16.99%) patients contracted COVID-19. Survival analysis showed that leprosy was associated with COVID-19 (p<0.001), but multivariate analysis showed that only COVID-19-positive household contacts (hazard ratio (HR) = 8.04; 95% CI = 4.93–13.11) and diabetes mellitus (HR = 2.06; 95% CI = 1.04–4.06) were significant risk factors for COVID-19. Conclusions/Significance Leprosy patients are vulnerable to COVID-19 because they have more frequent contact with SARS-CoV-2-infected patients, possibly due to social and economic limitations. Our model showed that the use of corticosteroids, thalidomide, pentoxifylline, clofazimine, or dapsone or BCG vaccination did not affect the occurrence or severity of COVID-19.

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